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1 PONCE SCHOOL OF MEDICINE P.0. BOX 7004, PONCE, PUERTO RICO July 1, 2014 Dr. Georgina Aguirre Acting Associate Dean for the Academic Affairs PSMHS Ponce, P.R Dear Dr. Aguirre: On October 5, 2012 and upon recommendation of Dr. Olga Rodríguez, I was appointed as Chair of the Ad-Hoc Committee for the development of an institutional policy on Security Systems and Emergency & Disaster Preparedness (SSEDP). The request was to develop a policy which should guide the institutional efforts in case of an emergency situation and help in the prevention of such an emergency occur. It should also comply with the requirements and standards of all the accreditation agencies of all the PSMHS academic programs. During the Academic Senate ordinary meeting held on December 4, 2013, the policy was presented, discussed and approved. It was recommended to acquire Campus on Cloud software technology to be able to protect all PSMHS data in case of a major disaster event. Attached please find the new policy with all the correspondent appendixes. Sincerely, Mayra L. Roubert Rivera, MS, DrPH Chair Security Systems and Emergency & Disaster Preparedness

5 4 A. Introduction All organizations including the academic environment are susceptible to disasters which can interrupt and affect their business. In the worst scenarios, these situations could shut them down permanently. Disasters are grouped into three main categories: natural disasters, manmade disasters and threats. Prior to a disaster and/or accident a contingency plan should be developed. The contingency plan should include the identification, prior to a disaster, of all critical procedures and resources necessary for the organization s survival. The objective of this policy document is to anticipate and plan for these emergency situations before they arise, decreasing and lessening their effects. A properly organized plan should take into consideration the safety of students, employees and patient first, followed by attention directed to infrastructure to minimize the business interruption, which usually follows a disaster. According to the Department of Homeland Security, it is important to work with the academic community to help campuses prepare for, protect against, respond to, recover from and mitigate crisis and emergency situations. Through these efforts colleges and universities will be able to reduce violence on campuses and bolster resilience and emergency planning processes for all types of hazards. B. Purpose: a. To develop and implement security systems and orient personnel about resources to provide a safe working and learning environment for employees and students at their regular duty and class hours on campus and at clinical teaching sites. b. To describe any special protections available to employees and students exposed to physical danger in the working and learning environment. c. To describe existing and proposed initiatives to prepare for natural and other disasters and emergencies, including planning activities, mandatory training, and resources available to the PSMHS School s students, faculty, and staff.

8 7 PSMHS CAMPUS LAYOUT Buildings 4 and 4A also house the Animal Research Facilities

9 8 D. PSMHS Quick References Guides Below are the institutional quick reference guides summarizing the original Contingency Plans or Manuals. Also PSMHS & Hospitals (Damas & San Lucas) Disaster and Infectious Diseases Exposures Policies are provided. 1. General Services Office Security Manual Originated by: Elbert Matos Caraballo, Security Supervisor Rossane West, General Services Official Approved by: President & Dean PSMHS (Dr. Joxel García García) Revised on: September 1, 2011 Chain of Comman d Personal Protection Recommend ations Criminal Acts Protocol Security Measures in Maintaining Physical Facilities President/Dean is the maximun authority at Ponce School of Medicine & Health Sciences (PSMHS) General Services Office Director Security Supervisor Security Guards Be alert at all times while at the PSMHS campus Do not take unnecesary risks while at PSMHS campus Walk through well-illuminated places. Ask for an escort if necessary. Avoid walking through premises alone Avoid taking shortcuts to your destination Security guards will proceed to investigate the case for grievance veracity Actions deemed criminal will follow PRELA bylaws including being referred to the PR Police Department Students involved in criminal acts will be referred to the Dean of Students Affairs for corresponding action Employees involved in criminal acts will be referred to the Office of Human Resources for its corresponding action PSMHS campus should mantain trees at a safe height. The illumination system will be subject to preventive manteinance measures. Parking lots will be available for students and employees. Guards are provided with portable radios and /or cell phones in order to communicate effectively at all times. Guards have the authority to directly intervene with unauthorized persons at PSMHS buildings and premises. Frequent preventive surveillance rounds are a must Clousure of areas as a preventive measure are recomended when necessary Parking Areas Designated parking areas are available for faculty, students, administrative personnel and visitors All vehicules should have a visible PSMHS parking sticker Emergenc y Numbers PR Police Department , , , Sexual crimes division , , Ponce School of Medicine & Health Sciences General Services Office ext 2265, & , (direct line) Security supervisor , Academic area guard gate , ext 2250 Administrative area guard gate ext 2249 Active shooter Stay in the building, proceed to a space that can be secured or barricaded, close and lock all windows and doors, and turn off the lights Get down on the floor and ensure that no one is visible from outside the room. Call 911. If the shooter enters your hall or room, try to remain calm, alert the police of the shooter's location. If it is not safe to speak, leave the line open so the dispactcher can hear what is happening. Keep your hands empty and in plain view at all times for police officers. Follow the direction of the emergency personnel Public Policy for Visitors Personal visits are not allowed at PSMHS premises during working hours unless strictly necesary because of an emergency. For these emergency situations a period of time of no longer than 10 minutes will be provided, in the parking lot.

10 9 2. Disaster Plan for PSMHS Animal Research Facilities (ARF) Animal Research Policy Num Originated by: Lizzette Laboy, Animal Research Facilities (ARF) Supervisor Approved by: Miriam Pérez, MPH PSMHS Safety Officer José Torres, Ph.D - Institutional Officer León Ferder, Ph.D Director of Research Development Rossane West, BSS General services and Facilities Officer Revised on: May 4, 2012 Policy: To anticipate the kinds of catastrophes that could befall our Animal Research Facility (ARF) and to outline appropriate responses. The potential consequences to animals include extreme heat, cold, or wet conditions, loss of lighting or ventilation, lack of food or water, and many hazards associated with escape or release. The policy of the ARF will be first to protect people from harm, then animals, then the scientific integrity of the ongoing research studies at the facility. Response Teams Action Committe I * Action Committee II Lizette Laboy, ARF Supervisor *Rossane West, General Services Officer Carmen Ruiz, ARF Animal Care Taker * Juan Rivera, Physical Services Supervisor Gregorio Cruz, ARF Animal care Taker * Miriam Pérez, Safety Officer Elbert Matos, Security Guard Supervisor * Elbert Matos, Security Guard Supervisor Juan Rivera, Physical facilities Supervisor Safety Issues People safety In case people cannot enter or stay at the ARF without risk to their own safety, they shoul be denied access or evacuated Decisions should be made by police, fire and PSMHS safety authorities Animal safety if animals are experiencing severe pain or distress they should require experimental cessation or euthanasia at the ARF Decisions should be made in consultation with as many of the relevant parties as are available, including Veterinary Medical Consultant (VMC), researchers and the ARF Supervisor ARF Veterinary in charge Dr. Kenneth Thompson, DVM, , , Protection of Research Integrity Priorities In case of a disaster and even if the ARF is undamaged and functional, the response staff and users could be limited by hazardous traveling conditions, among others. In those cases, personnel available should follow these priorities: Animal hydrating and nutrition Essential veterinary medical care Bedding change and other first-level sanitation Other care measures will be taken if no risks are identified Before the storm Action Committee I activation to conduct an inspection for identifying last minute needs at the facility Provide food and water to all animals Ensure enough CO2 on hand to euthanize animals, if necessary Fill two 33 gallons containers with water and leave them at the wash area Check that all flashlights are working properly Principal investigators should leave special instructions for the care of their experimental animals to the ARF Supervisor Have available two filter masks in the wash area in the case of concentration of objectionable odors due to animal urine and feces Preparednes s Measures After the storm ARF security guard inspection to assess if the Facility Supervisor or Safety Officer should be notified Action Committee I verification of animal wellness Action Committee II entrance if Action Committee I do not reach the ARF to provide water and food to the animals In case of blackout of electric light, the emergency electric plant should starts automatically within 15 seconds Monthly preventive maintenance check outs are provided by Mr Eddie William Rivera ( ) In the event of an air conditioning malfunction, Action Committee I should open all doors to allow air to circulate and fans will be power on If emergency power plant does not operate for more than a bussines day and/or temperature exceeds 79ºF, animals will be relocated to the surrounding ARF facilities until everything is back to normal

11 10 3. Emergency & Natural Disaster s Contingency Plan Originated by: Miriam Pérez, MPH PSMHS Safety & Health Officer Approved by: Dra. Olga Rodríguez de Arzola Purpose: to effectively communicate preventive measures, actions and evacuation routes to all Ponce School of Medicine & Health (PSMHS) Sciences community. The Emergency Contingency Plan (ECP) provides for the protection of life and property, including physical facilities and equipment. Contingency planning is the identification, prior to a disaster, of all critical procedures and resources necessary for the institutional survival. The purpose of such a program is to anticipate, and plan for these emergency situations before they arise to decrease their potential effects. The plan should take into consideration the safety of staff and students first, and should also minimize the business interruption, which usually follows a disaster. 3.1 Emergency Contingency Plan (ECP) Guidelines Chart General Data Institution Name: Ponce School of Medicine & Health Sciences Direction: Zona industrial Reparada 2, # 388, Ponce By Pass, Ponce, P.R Phone: Persons to contact in case of emergency: Facilities Director, General Services Oficial, Mantainance & Physical Services Supervisor, Security Supervisor, Human Resources Director, Receptionist Facilities Description MATCOR, Instituto Tecnológico de Ponce Old Building, Administration Building, Academic Building, MULTIMED, Psychoneurometrics, CAIMED, PRIDCO 3 Building Plan Organization Security Committee components: Administration Dean, General Services Director, General Services Oficial, Physical Services Supervisor, Security Supervisor, Purchasing Director The committee will be responsible of the plan developing, distribution and dissemination.

12 Prevention & Control Fire Guidelines Smoking is prohibited at the PSMHS premises Doors, halls and stairs should be free of obstacles at all times All exits should be identified and well illuminated Sprinklers and fire alarms will be inspected on a regular basis Fire extinguishers and hoses should be inspected, visible and ready to uses at all times Fire Department inspections should be performed on a year basis PSMHS staff and students should be properly trained to manage the fire extinguishers Emergency Plan will be frequently revised & distributed to the PSMHS community No large amounts of flammable materials should be storage on PSMHS premises Fire drills will be coordinated and executed with the Fire Department at least yearly In case of fire or smoke presence you should call the receptionist and security to let them alert all PSMHS community with instructions Only electrician with license to operate in Puerto Rico will inspect and perform any electric job at PSMHS

13 Hurricane Plan Purpose: To manage emergencies including storms and hurricanes. To respond to those events before, during and after the natural phenomenon. Measures will be in effect immediately after the National Weather Authorities warning or watch alerts. Health &Safety Office General Services Office responsibiliti es To notify all PSMHS community about the natural phenomenom by , internal mail and PSMHS webpage. The notificaction will be accompained by instructions related to the following: Computers and server protection; Equipment disconnection advice; To retrieve any equipment or material near doors and windows to avoid property damage; Update and distribute emergency numbers and contact persons; To coordinate with maintenance personnel and Psysical Installations all necessary measures to avoid property damage or lost To coordinate with personnel of Security, Physical Plant & Manteinance a about the preventive measures to take to secure PSMHS properties. These are: structure anchorage, secure windows and install window shutters, identify filtrations, check diesel tanks and emergency electric plants, perform preventive checks to PSMHS vehicles, verify vehicle gasoline levels, remove fallen trees and debris, check guards cellulars batteries charges levels. Human Resources To communicate with all PSMHS personnel about the weather situation and to asist in communicating to the news Receptionist To page the PSMHS community instructions related to the emergency, including the following: emergecy numbers, security measures above mentioned To be sure all PSMHS departments and programs are aware of institutional secure measures Security To verify all the equipment is ready including: capes, boots, portable radio, flashlight with baterties, cellulars, emergemcy phones, emergency contact numbers, walkie talkies and chargers, secure PSMHS flags. Students Affairs To designate an area "shelter'' to be available for students. The designated area should have phone and electric extentions. To maintain communication with students and the Dean of Academic Affairs in maters concerning the academic issues. Physical Plant & Maintenanc e To check they have all emergency and personnel protection equipment including: security boots, portable radio, flashlights, batteries, emergency phones and contact numbers and names...walkie talkies and chargers, secure PSMHS flags., Security belts and boots, to install tormenteras, to perform damage inspections, to help staff and students in need, to coordinate with maintenance personnel...

14 Earthquake Plan Due to Puerto Rico s geographic location at an area of constant tectonic movement, it is important to identify risks before, during and after an earthquake. The PSMHS Health & Safety Officer is responsible of the development of a protocol to identify those risks to be able to preserve the health and well-being of PSMHS employees and students. The protocol includes some conferences in coordination with the pertinent governmental agencies to be able to get ready for an important tectonic event. Before an earthquake to survey all working areas and facilities to identify risks including: heavy objects that could fall down during the event building structural damage evacuation routes not obstructed loose or defective electric lines During an earthquake Stay calm Move away from doors and glass windows You must duck, cover and hold on Don't stand in the door frames Do not run outside of the building If you are outside, move away from the posts, trees and high buildings If you are in a vehicle you must stop away from posts, trees or tall buildings After an earthquake Await instructions to vacate the building Be kept alert to the aftershocks Identify the risks or hazards that may have been caused by the earthquake: electrical breakdowns, spills of chemicals, gas leaks among others Be alert to tsunami advisories for the transfer to a safe place Do Not return to the work area until it has been confirmed that there is no danger

16 15 4. BLOOD BORNE PATHOGENS POLICY Originated by: Miriam Pérez, MPH PSMHS Safety Officer Purpose: To provide an exposure control plan (ECP) to eliminate or minimize occupational exposure to blood borne pathogens in accordance with OSHA standard 29 CFR Occupational Exposure to Blood Borne Pathogens. Employee Exposure Determinatio n Methods of Implementati on and Control Exposure Control Plan Engineerin g Controls and Work Practices Phlebotomist at clinical labs Laboratory technicians Principal Investigators Universal Precautions, Personal Protective Equipment (PPE) All employees can review this plan at any time by contacting PSMHS Safety Officer Safety sharps/needles system Protective shields. Sharps containers Mechanical pipettes Medical Waste Containers Biological cabinets, hoods Specimen Containers Personal Protective Equipment (PPE) PPE includes the following: (1) Gloves, Protective Clothes (2) Face Mask, Eye Protection All employees using PPE must observe the following precautions: (1) wash hand inmediately as soon as possible after removing gloves or other PPE (2) remove PPE after it becomes contaminated and before leaving the working area (3) used PPE may be disposed at a biohazard waste containers (4) never wash or decontaminate disposable gloves for reuse Housekeep ing Regulated wastes should be placed into provided containers or closable bags. These should be appropriately labeled and closed securely prior to removal to prevent spillage of contents during handling. Contaminated sharps should be discarded immediately in containers that are closable, puncture resistant, leak proof on side and bottoms. Hepatitis B Vaccinati All current employees whose work involves occupational exposure to bloodborne pathogens should be offered the Hepatitis B Virus (HBV) vaccine. on All new employees covered under this program will be offered the HBV vaccine after completion of training and within one week of hiring. Exposure Incident Report exposure immediately; you may need immediate therapy. Needlestic ks/punctur Wash the affected area with antiseptic soap and warm water for 15 minutes e wounds Mucous Flush the affected area for 15 minutes at the eyewash station. membrane exposure For all exposure incidents Notify Principal Investigator, manager or supervisor (if available) to initiate accident or exposure incident report. Seek medical assistance immediately (within 1-2 hours) from MultiMed at PSMHS or if necessary from a Hospital. It is necessary promptly complete a Report of Incident.

17 16 5. PSMHS EXPLOSIVE EMERGENCY POLICY Originated by: Miriam Pérez, MPH PSMHS Safety Officer Purpose: To manage and dispose explosives appropriately and in compliance with the Puerto Rico Explosive Act, Num 134, June 28, Explosive Definition: According to 49 CFR 176.2, explosive substance means a solid or liquid material, or a mixture of materials, which is in itself capable by chemical reaction of producing gas at such a temperature and pressure and at such a speed as to cause damage to its surroundings. Explosive management: An explosive license is required by the Puerto Rico Police Department for any individual or institution to permit the use of these materials. Ponce School of Medicine & Health Sciences is granted the license for the use of small amounts in their research laboratories. People who make use of these explosive materials are properly qualified and know how to properly use such materials. Below are the standard protocols or procedures for the handling, the maintenance & storage and the disposal of explosive material. Handling Do not open boxes containing explosives by using metal tools It is prohibed to smoke or have matches, kerosene lanterns, or any other form of fire around explosives areas It is forbidden to smoke in the PSMHS and its surroundings It is forbidden to carry explosives or any substance that can be used to manufacture explosives in the pockets of clothing or any other part of the body The presence of unauthorized persons is prohibited in the laboratories where explosive materials are being handled Do not use explosives that shows signs of deterioration during a thunderstorm; Do not use explosive materials that have become wet even after drying. Maintenance & Storage Explosives should be: in the custody of laboratory supervisors used first those that have more storage time free of any device that produces sparks near explosive or flammable material not srorage in damp places or near heat sources, or near metal sparking Disposal Explosives will be: disposed as hazardous wastes in coordination with Safety Kleen company logged and monthly reported to the Explosives Division of the Puerto Rico Police discarded as hazardous materials when expired

19 18 b. Natural Risks Threats Contingency Plan HURRICANE, STORM, TORRENTIAL RAINS INITIAL EVALUATION: Inspection of all communications rooms and the Data Center PREPARATIONS AND SAFEGUARD MEASURES: Notifications to Staff; Backups; Other measures AT THE END OF DAY: Proceed to TURN OFF communications equipment in areas that are determined from the initial assessment and follow up assessments that may be at risk DATA CENTER ROOM SERVERS: Data Center, central servers and communications equipment systems should be maintained ON and operating normally unless other instructions are provided PRESS RELEASES/WEBSITE: notify users of affected areas that the system will be unavailable 1 hour before culminating work; advise of the expected recovery time and when the system will be back online. PROTOCOL FOR DATA CENTER FLOOD/WATER FILTRATION BY PIPES BREAK Immediately notify the office of general services in the event of any flooding in the the Data Center area Take the following safety measures: Under no circumstances stand on wet floor (electrical hazard); if no risk is anticipated, move equipment or personal properties; Turn off computer and unplug the power; Provide some sort of barrier to contain the flood; in case of danger, evacuate the area inmediately AS A RESULT OF RAIN Assess the situation, turn off the system following the general PSMHS security measures mentioned above. FIRE General procedure:the first person who discovers a fire in a building or its surroundings should immediately notify the physical plant Supervisor or safety officer using the nearest phone; students and employees should move away of the immediate danger under the direction of available staff DATA CENTER: Data Center area is fully equipped with a fire suppression system; in case of small fires and if no harm is identified turn the supression system to Lock Out mode and use the fire extinguisher; do not try to extinguish a fire alone. Otherwise, left the suppression system to activate automatically, or activate manually. EARTHQUAKE Follow the same institutional Contingency Plan instructions: research building should be evacuated due to the nature of its activity In case you are at the Data Center: remain calm; If you are in the interior of a building, stay inside and seek protection under a table, desk, or other strong cabinet, if possible, lying against an interior wall protecting the head and neck;. If you are on the road, drive away from tunnels, bridges and lines of service and remain in the interior of the vehicle. After the earthquake: Examine whether there are wounded people to provide first aid; Verify if there are people trapped or missing; Verify lines for gas, water and electricity; Check damages in building and potential safety problems during the secondary seismic movements; Tune in to the radio and watch the instructions of Civil Defense; Do not use the phone unless it's an emergency.

20 19 c. Human Threat Contingency Plan OPERATOR OR TECHNICIAN ERROR The technician must notify the Director of any system error and will provide information about possible causes and estimated downtime Notify the affected areas/users Design and implement a corrective action plan IMPLANT OF VIRUSES OR MALICIOUS CODE Verify if the infection has been registered and removed by the monitoring system, and/or antivirus/spam system If the infection was not remove by the antivirus system, proceed to: Isolate the infected equipment (computers or servers should be disconnected from the net) Proceed to install and/or update Antivirus and removal tools until it is solved Verify equipment before conecting them to the net Connect equipment and perform a continuous monitoring for at least 24 hours SABOTAGE AND TERRORIST ATTACKS CYBER ATTACKS Notify MIS Director immediately As a general procedure, system backups should be verified, updated and kept in a safe box on campus with a duplicate "off site" Evaluate and work according to the scenario. In case of cyber attacks proceed with Implant of Viruses procedure above. In the event of extreme attacks, via Internet, disconnect PSMHS main system from the Internet by disconnecting or turning off the router In case of vandalism, do not alter the scene, and notify inmediately the security supervisor and MIS Director Additional procedures will be determined by the MIS Director, or the Systems Analyst

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